该研究中，使用2000年纵向健康保险数据库和台湾重大伤病患者登记进行一项基于人群的巢式病例对照回顾性研究。1998-2010年期间，一个由12467例没有骨质疏松症病史的女性患者组成的恶性肿瘤队列，然后639例后来发生骨质疏松症患者作为骨质疏松组，并对其进行评估。对照组为从恶性肿瘤队列中挑选的没有骨质疏松症，并与每例骨质疏松症病例的年龄、癌症诊断时间2：1频率匹配的患者。使用Logistic回归评估比值比和95%可信区间，并应用多变量模型控制年龄。
该研究结果表明，接受吗啡治疗的女性癌症患者发生骨质疏松症风险比非吗啡使用者低10%，但这个风险的降低没有意义。在双磷酸盐治疗的患者中，吗啡组发生骨质疏松症的几率显着降低非吗啡组。
该研究发现，吗啡治疗与骨质疏松症的发生无关，而双磷酸盐在台湾女性恶性肿瘤患者的骨质疏松症发生过程中加强吗啡的保护作用。
原文阅读：Bisphosphonate treatment may reduce osteoporosis risk in female cancer patients with morphine use: a population-based nested case-control study
Abstract
Chronic use of morphine is a risk factor for endocrinopathy and osteoporosis. Bisphosphonates accentuated the protective effect to develop osteoporosis in female patients with malignancy with morphine treatment.
INTRODUCTION: This study investigates the risk of osteoporosis associated with morphine use by comparing the incidence of osteoporosis in female cancer patients treated with and without morphine.
METHODS: A population-based nested case-control retrospective analysis was performed using the Longitudinal Health Insurance Database 2000 and Registry for Catastrophic Illness Patients of Taiwan. A malignancy cohort of 12,467 female patients without a history of osteoporosis during 1998-2010, and then 639 patients who subsequently developed osteoporosis as the osteoporosis group, were evaluated. Control-group patients were selected from the malignancy cohort without osteoporosis and frequency matched to each osteoporosis case 2:1 for age, year of cancer diagnosis, and index year. Logistic regression was used to estimate the odds ratios and 95% confidence intervals, and the multivariable model was applied to control for age.
RESULTS: Female cancer patients who received morphine had a 10% lower risk of developing osteoporosis than non-morphine users, but this risk reduction was not significant. For patients treated with bisphosphonates, the morphine group had significantly lower odds in developing osteoporosis than the non-morphine group.
CONCLUSION: Morphine treatment is not associated with the incidence of osteoporosis, and bisphosphonates accentuated the protective effect of morphine in the development of osteoporosis in female patients with malignancy in Taiwan.
